The visual recovery and refractive results of 33 consecutive patients (66 eyes) undergoing standard endocapsular cataract extraction in one eye and simultaneous phacoemulsification in the fellow eye are reported. One surgeon performed all the operations. Surgically induced astigmatism was evaluated for the two techniques in terms of: (1) the proportion of eyes with a refractive cylinder of 1.5 dioptres (D) or less; (2) the interocular difference in post-operative astigmatism. Eyes undergoing phacoemulsification had a significantly lower mean induced cylinder (paired Student's t-test: t = 3.729; p < 0.001) and were more likely to exhibit a cylinder of 1.5 D or less (chi-squared test with Yates' correction: chi 2 = 7.88; p < 0.01) than the nuclear expression group. For paired eyes less post-operative astigmatism (Wilcoxon's signed rank test: T = 92; p < 0.01) was seen in the phacoemulsification eye. At the time of the last post-operative assessment a significantly higher proportion of phacoemulsified eyes achieved a corrected Snellen visual acuity of 6/6 or better than their fellow eyes (McNemar's test: p < 0.01). The results of this unique cohort of patients confirm the beneficial effects of phacoemulsification on astigmatism and visual outcome in the early post-operative period.
Purpose To Utilize OCT-A to measure the change in size (mm 2 ) and density (flow index) of choroidal neovascular membranes (CNVMs) from baseline to week 52 of treatment-naïve wet age-related macular degeneration (wARMD) patients receiving intravitreal aflibercept injections (IAI). Methods Patients were treated with IAI at baseline, month 1 and month 2 and then every other month for a total of 12 months. Along with clinical examination and best corrected visual acuity (BCVA), OCT-A 6and 3-mm scans were acquired at every visit between May 2017 and January 2019. Data from baseline, week 12 and week 52 were analyzed prospectively and included in the final analysis.Results Twenty-five eyes from 23 patients were included in the study. The mean BCVA at baseline and week 52 increased from 20/125 to 20/80, respectively (p \ 0.001). The mean CST at baseline and week 52 decreased from 330.48 to 222.40 lm, respectively (p \ 0.001). 1Seventeen patients (18 eyes) completed all protocol-based 6 9 6 mm and 3 9 3 mm OCT-A scans. In this subgroup, 6-mm OCT-A scans revealed that the mean size of the CNVM before and after IAI was 1.21 mm 2 and 0.56 mm 2 , respectively (p \ 0.001), while the 3-mm OCT-A scans at baseline and week 52 demonstrated a decrease in mean size of the CNVM from 0.89 to 0.37 mm 2 , respectively (p \ 0.001). The 6-mm perfusion density map revealed no difference at either time points. Conclusions OCT-A provides a useful approach for monitoring and evaluating the treatment of intravitreal aflibercept for CNVMs. Mean size of CNVMs can be identified by 3-or 6-mm scans, but without machine learning, it requires extensive segmentation. While reproducibility and clear delineation of CNVMs in wARMD using OCT-A is challenging, OCT-A does offer the ability to monitor CNVM size changes during treatment and may offer another biomarker to assist in assessing treatment response.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.